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Organization
VISALIA PHARMACY INC
Active
Organization
VISALIA PHARMACY INC
Active
Other names
Visalia Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
HANY MANSOUR DR (OWNER)
(559) 667-9292
Entity
Organization
Contact information
Practice address
444 NW 3RD AVE, VISALIA, CA 93291-3624
(559) 667-9292
(559) 667-9293
Mailing address
444 NW 3RD AVE, VISALIA, CA 93291-3624
(559) 931-1122
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2056FQ6S
—
CA
Enumeration date
12/16/2019
Last updated
06/02/2020
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